Pediatric emergency care
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Pediatric emergency care · Dec 2004
Clinical TrialThe anesthetic effectiveness of lidocaine-adrenaline-tetracaine gel on finger lacerations.
To determine the effectiveness of lidocaine-adrenaline-tetracaine (LAT) in providing adequate anesthesia for the repair of finger lacerations and to monitor the risk of digital ischemia following application of LAT gel to finger lacerations. ⋯ LAT gel appears to be a safe and effective means of providing anesthesia for the repair of simple finger lacerations in children. It was most effective on the dorsal surface of the finger.
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Pediatric emergency care · Dec 2004
Pain, position, and stylet styles: infant lumbar puncture practices of pediatric emergency attending physicians.
Lumbar punctures (LPs) are common emergency department (ED) procedures. Few pediatric studies exist to define training, guide practice, or indicate preferred methods for infants. While pain control is recommended, no recent studies indicate prevalence of analgesic use since the advent of topical anesthetics. We surveyed academic pediatric ED physicians to assess training and technique preferences and to highlight pain control usage. ⋯ Analgesia is underused for infant LPs. Advancing the needle without a stylet is not uncommon. Response rate to regular mail surveys was much higher.
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Pediatric emergency care · Dec 2004
Multicenter StudyThe effect of fasting practice on sedation with chloral hydrate.
Infants undergo various painless imaging procedures frequently. Mild sedation is required in such cases to reduce anxiety as well as to ensure optimal performance of the procedure. The most frequently used sedative as a single drug is chloral hydrate. The issue of preprocedural fasting is a subject of contention. The purpose of this study was to assess the effect of the American Academy of Pediatrics (AAP)/American Society of Anesthesiology (ASA) fasting practice guidelines on the efficacy and success of the sedation with chloral hydrate. ⋯ Fasting was associated with an increased failure rate of the initial sedation. As a consequence, an increased total dose of chloral hydrate was required inducing a prolonged sedation time. Presumably, this is a result of the fact that a hungry child is irritable and therefore more difficult to sedate.
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Pediatric emergency care · Dec 2004
Case Reports"I can't taste ice cream": an unusual case of tinnitus and dysgeusia.
Auricular foreign bodies are usually presented to the emergency department in an easily recognizable fashion. We report the case of a 16-year-old male who presented to the emergency department with complaints of unilateral tinnitus and dysgeusia. He denied any history of injury except for falling from his bike in the woods earlier that day. ⋯ On evaluation, the chorda tympani nerve was found to be severed along with disruption of the ossicles. This is an unusual presentation for an aural foreign body, and the resulting injury of the chorda tympani is not well published. One should consider the possibility of injury to the middle and inner ear and perform the necessary clinical evaluation before and after removal of aural foreign bodies.